POS1500-HPR BABS ON A MISSION: AN EXPERIMENTAL STUDY ON THE EFFECTS OF MESSAGE FRAMING AND THE USE OF A PATIENT TESTIMONIAL ON BELIEFS AND INTENTIONS OF OSTEOARTHRITIS PATIENTS
Authors: J. Oomen, C. Van den Ende, H. Das
Journal: Annals of the Rheumatic Diseases (2022)

Background It is important that patients receive appropriate and reliable information that effectively targets beliefs in order for them to adhere to health behaviors. Framing (focusing on either gains or losses; [1]) is one of the most commonly used techniques in health communication to influence beliefs. In addition, the use of a testimonial in educational material might strengthen effects as intentions to adhere to health behaviors seem to rely strongly on testimonies of other patients. However, little is known about the potential of framing and patient testimonies to impact beliefs and change in health behaviors in osteoarthritis (OA). Objectives To study the effects of 1) message framing and 2) patient testimonies on beliefs about and intentions to be physically active and use pain medication. Methods We conducted an experiment consisting of a 2 (gain-frame vs loss-frame) x 2 (testimonial versus informative message) factorial design. Members of a research panel (n=639) with a self-reported diagnosis of knee OA were invited to participate. Participants were randomized into one of four video messages applying framing and the use of either a testimonial or facts. The messages (mean (SD) words 1073 (129)) were audiotaped by the same female speaker, subtitled, and complemented with images (duration of ~10 minutes). The four different combinations were: informative-loss (“ If you are not physically active, this can lead to more pain[…].”), informative-gain (“ If you are physically active, this can lead to less pain[…].”), testimonial-loss (“ When I wasn’t physically active, I experienced more pain[…].”), testimonial-gain (“ When I was physically active, I experienced less pain[…].”). After this video, participants filled out a questionnaire on socio-demographic and disease characteristics, and rated 3 statements concerning beliefs on a 7-point Likert scale (completely disagree – completely agree), and one 7-point Likert scale item on intentions (I do not do this now and am not planning doing this – I am doing this already for more than 6 months) each for both physical activity and pain medication based on the Theory of Planned behavior questionnaire [2]. ANOVA was used to assess the main and interaction effects of framing and the use of a testimonial on mean beliefs and intentions. Results A total of 154 respondents completed the questionnaire (Table 1). Framing nor the use of a testimonial impacted beliefs and intentions on physical activity. Loss framing resulted in more positive beliefs about pain medication (mean (SD) 5.5 (1.6)) than gain framing (mean (SD) 4.9 (1.9), p=.04, 95% CI [0.0, 0.1]). Within the loss frame, the patient testimonial scored significantly more positive on pain medication beliefs (mean (SD) 5.0 (1.7)) than the informative message (mean (SD) 6.0 (1.1), p=.02, 95% CI [0.1, 1.6]) (Figure 1). Table 1. Characteristics of participants (n=154) Female, n (%) 110 (71) Age (in years), mean (SD) 62.3 (7.9) BMI, mean [kg/m 2 ], (SD) 27.3 (4.4) Daily functioning (KOOS a ; 0-100), mean (SD) 64.5 (18.0) Pain VAS (0-10), mean (SD) 4.6 (2.2) Symptoms for more than five years, n (%) 96 (62.3) Presence of OA in other joints, n (%) 85 (55.2) Knee replacement, n (%) 32 (20.8) Presence of comorbidities, n (%) 111 (72.0) Figure 1. Interaction of framing and the use of a patient testimonial on beliefs about pain medication Conclusion This study showed that stating the disadvantages of nonadherence to pain medication resulted in more positive beliefs about pain medication than stating the advantages of adherence. The use of a patient testimonial within this loss frame strengthened the effect. Our findings indicate that health care providers should be aware of the potential effects of emphasising either gains or losses in educational messages to their patients. References [1]Rothman, A.J. and P. Salovey, Shaping perceptions to motivate healthy behavior: the role of message framing. Psychol Bull, 1997. 121 (1): p. 3-19. [2]Ajzen, I., Constructing a Theory of Planned Behavior Questionnaire . 2006. 1-12. Disclosure of Interests None declared